Appendix A

e-Gamer Personal Survey Sheet

Name:_______________________________________________
____
Age: _____________________
Address:
_________________________________________________
Telephone Number/Contact Number:
_________________________
Name of School: _________________________________
Grade and Section: ________________________________
Name of Adviser:
_________________________________________
----------------------------------------------------------------------------------------------Please answer the following question.
Have you tried games in the Playstation?_____________
If yes, what games do you play? Name them.
____________________________________________________
_______
If not, do you want to play? ______________
If your answer is yes, please have this form signed by your
guardian.

Appendix A
e-Gamer Personal Survey Sheet

I am allowing my son/daughter to participate in the activity

I am not allowing my son/daughter to participate in the
activity
_________________________________
Name and Signature of Guardian